Lee SM, Seo JS, Kwak SH, et al. - This study was sought to ascertain whether bone density associates with radiologic and clinical outcomes after screw fixation of displaced intra-articular calcaneal fractures (DIACF) with the sinus tarsi approach. A total of 43 consecutive cases of unilateral DIACF between March 2015 and December 2017 were retrospectively evaluated. Preoperative, postoperative, and last follow-up calcaneal lateral and axial radiographs were applied to conduct radiologic evaluations. In all patients, they conducted preoperative CT scanning of both injured and uninjured calcaneus at one scanning and dual x-ray absorptiometry (DXA) scans were collected. They ascertained hounsfield unit (HU) measurement values by placing an elliptical region of interest confined to the cancellous region of the uninjured calcaneus. They evaluated clinical outcomes at a minimum of 12 months postoperatively using Foot and Ankle Outcome Scores (FAOS). The data reveal that after screw fixation of DIACF, reduced preoperative bone density significantly associated with decreased Böhler's angle, widening of calcaneal width, and inferior short-term clinical outcomes. By evaluating bone density applying HU value in area where DXA cannot be conducted, such foot bones, ascertaining if different fixation techniques or systemic treatments can be tailored to bone density could help in optimizing clinical outcomes.